Differential Diagnosis > Morphology > Reaction Patterns > Dermal > The Five L's

The Five L's

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red indurated dermal plaques involving the face
lymphocytic infiltrates: (some of the infiltrates are superficial and deep perivascular like Jessner's, others are nodular or diffuse infiltrates of lymphocytes as in lymphocytoma cutis)  the dermis is infiltrated with lymphocytes to create these red dermal plaques
two of five treated with plaquenil (tumid LE and PMLE)

 

The "classic" five:

1.LE more specifically "tumid LE"
2.PMLE (plaque type)
3.Lymphoma cutis
4.Lymphocytoma cutis
5.Jessner’s Lymphocytic infiltrate

 

 

hmtoggle_plus1The Five L's extended: (clinically, because not actually lymphocytic)
1.Alopecia mucinosa
2.Granuloma faciale
3.Actinic granuloma
4.ALH with eosinophilia
5.Sweet’s syndrome*

 

*Some would replace Sweet's (which is usually fairly distinct clinically) with Sarcoid (the great imitator)